• MAKITE SIMON LATI Clinical Pharmacist, Department of Pharmacy, Kangundo Level 4 Hospital, P. O Box 1002-90115, Kangundo
  • NYAMU GITONGA DAVID Department of Pharmaceutics and Pharmacy Practice, University of Nairobi, P. O. Box 19676-00202, Nairobi
  • ROSALINE NJERI KINUTHIA Department of Pharmacy, Kenyatta National Hospital, P. O. Box 20723-00202 KNH, Nairobi



Potential drug-drug interactions, Diabetes, Hypertension, Antihypertensives


Objective: To characterize the predictors of potential drug-drug interactions among adult diabetic hypertensive outpatients at Kenyatta National Hospital.

Methods: This cross-sectional study collected and analyzed data on potential drug interactions from 104 diabetic hypertensive outpatients (aged ≥18 y) at the Department of Endocrinology Outpatient Clinic of Kenyatta National Hospital from 1st May 2019 to 31st August 2019. The main outcome measure was the prevalence of potential drug-drug interactions and their predictors among the study population.

Results: There was a female preponderance (70.2%). The mean age of the study participants was 61.6 y (SD±10.8). The prevalence of potential drug interactions was high at 57.7%. The average number of drug interactions was one interacting pair per patient, with a majority of the prescriptions (81.0%) having moderate drug-drug interactions. Patients receiving>2 drugs were almost three times more likely to have drug-drug interaction compared to those prescribed ≤ 2 drugs (AOR=2.79; 95% CI: 1.11-7.28); p=0.029). Participants who were at stage 4 of hypertension were 2.5 times more likely to have a drug-drug interaction compared to the other stages of hypertension (AOR=2.52; 95% CI 1.31-4.89; p=0.007).

Conclusion: Polypharmacy and stage 4 hypertension are independently associated with drug-drug interactions among patients with both diabetes and hypertension. Future studies should characterize the specific type of drug interactions and possible targets of minimization of drug-drug interactions.


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Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension and cardiovascular disease: Clinical Insights Vascular Mechanisms 2018;34:575–84.

Seuring T, Archangelidi O, Suhrcke M. The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics 2015;33:811–31.

Ogunsina MA, Anumah FO. Prevalence and correlates of hypertension and diabetes mellitus in an urban community in North-Western Nigeria. Pan Afr Med J 2018;8688:1–5.

Muchira J, Stuart Shor E, Kariuki J, Mukuna A, Ndigirigi I, Gakage L, et al. Distribution and characteristics of risk factors for cardiovascular–metabolic disease in a rural Kenyan community. Int J Afr Nursing Sci 2015;3:76–81.

Cham B, Scholes S, Fat LN, Badjie O, Mindell JS. Burden of hypertension in the Gambia: evidence from a national World Health Organization (WHO) STEP survey. Int J Epidemiol 2018;47:860–71.

Ker JA. Management issues in hypertensive diabetics. Medpharm Association 2011;53:144-9.

Seedat Y, Rayner B. The abridged South African hypertension guideline 2011. South African Family Practice 2012;54:111-6.

Mohan V, Seedat YK, Pradeepa R. The rising burden of diabetes and hypertension in Southeast Asian and African regions: need for effective strategies for prevention and control in primary health care settings. Int J Hypertension 2013;1–14.

Marwa I, Gugu G, Mtshali G. Comorbidity of diabetes and hypertension and available management strategies in Eastern African Region. Journal of Nursing and Health Science; 2017. p. 1–9.

Emily P, Kelechi C, Krista L. Diabetic medications and polypharmacy. Diabetic Medications Polypharmacy Emily Richmond 2016;31:17-31.

Shanmugam S. Chapter-28 management of hypertension in diabetes. Diabetes Mellitus 2006;124–8.

Manikandan R, Nandamuri SSS, Logaraj M. Assessment of medication adherence among patients with hypertension and diabetes mellitus in urban field practice. Asian J Pharma Clin Res 2018;11:130-2.

The health of the people: the African regional health report. Brazzaville: World Health Organization, Regional Office for Africa; 2006.

Maharani DD, Syafhan NF, Hersunaryati Y. Drug-related problems in hospitalized geriatric patients with diabetes mellitus. Int J Appl Pharm 2018;10:142-8.

Puspitasari AW, Azizahwati A, Hidayat AR. Analysis of potential drug interaction on antihypertension drugs prescription in community health center of sukmajaya district in period of June-November 2015. Asian J Pharm Clin Res 2017;10:61-5.

Ofori Asenso R, Agyeman A. Irrational use of a medicines-a summary of key concepts. Pharmacy 2016;4:35-48.

Ogamba E. Diabetes and hypertension in kisii teaching and referral. MPharm Dissertation. University of Nairobi; 2016.

Martha S, Mateti U, Neerati V, Sivva D, Thiruthopu N. Assessment of drug-drug Interactions in hypertensive patients at a superspeciality hospital. Avicenna J Med 2015;5:29-35.

Huri HZ, Wee HF. Drug related problems in type 2 diabetes patients with 13. Hypertension: a cross-sectional retrospective study. BMC Endocrine Disorders 2013;13:2-14.

Hazari MAH, Ram Reddy B, Uzma N, Santhosh Kumar B. Coagulation impairment in type 2 diabetes mellitus. Int J Diabetes Mellitus 2015;3:36–9.

Why Choose Micromedex? Truven Health Analytics. Available from: DX.pdf. [Last accessed on 04 Mar 2019]

Kim MJ, Lim NK, Choi SJ, Park HY. Hypertension is an independent risk factor for type 2 diabetes: The Korean genome and epidemiology study. Hypertension Res Nat Publishing Group 2015;38:783–9.

Ayah R, Joshi MD, Wanjiru R, Njau EK, Otieno CF. A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya. BMC Public Health 2013;13:371-82.

Bhatta M. A prospective, cross-sectional study on cost and adherence of antidiabetic prescriptions at a tertiary care teaching hospital in South India. Value in Health; 2014. p. 17-9.

Guantai EM, Magot AA, Karimi PN, Maru SM, Nyamu DG. Identification and characterization of potential drug interactions in hypertensive patients in a Kenyan tertiary hospital Identification and characterization of potential drug interactions in hypertensive patients in a Kenyan tertiary hospital. Afr J Pharmacol Ther 2018;7:7–12.

Alwhaibi M, Balkhi B, Alhawassi TM, Alkofide H, Alduhaim N, Alabdulali R, et al. Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMJ Open 2018;8:1136-44.



How to Cite

LATI, M. S., N. G. DAVID, and R. N. KINUTHIA. “THE PREDICTORS OF POTENTIAL DRUG-DRUG INTERACTIONS AMONG DIABETIC HYPERTENSIVE ADULT OUTPATIENTS IN A KENYAN REFERRAL HOSPITAL”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 12, no. 12, Dec. 2020, pp. 63-67, doi:10.22159/ijpps.2020v12i12.38810.



Original Article(s)